Individual
RENE KUKKAMALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4000
(859) 258-6203
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-6200
(859) 258-4000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
56420
KY
207P00000X
Emergency Medicine Physician
R6033
TX
Other
Enumeration date
04/20/2015
Last updated
05/01/2023
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